Síntomas óticos y síndrome del dolor miofascial en musculatura temporomandibular y esternocleidomastoideo: Estudio de un caso / Otic symptoms and myofascial pain syndrome in temporomandibular and sternocleidomastoid musculature: A case study

Introducción El dolor de oído y la alteración de la audición son motivos de consulta muy frecuentes. El dolor de oído referido puede deberse a alteraciones temporomandibulares y puntos gatillo en la musculatura cervical. La hipoacusia se relaciona con la presencia de puntos gatillo en musculatura cervical y mandibular. Aunque se han observado efectos beneficiosos sobre esta musculatura tras la utilización de terapia manual y punción seca, la literatura al respecto sigue siendo escasa, motivo por que se realizó el actual estudio. Objetivo Conocer los efectos de un tratamiento basado en la técnica suiza y punción seca en la musculatura temporomandibular y esternocleidomastoideo a corto plazo sobre el dolor de oído e hipoacusia, en una paciente de 24 años. Material y métodos Estudio de un caso. Se realizó una valoración previa al tratamiento y otra al finalizar para valorar sus efectos, mediante audiometría y escala visual analógica. Se programó una sesión de 50 min, semanalmente, durante cuatro semanas. Durante el tratamiento se aplicó la técnica suiza y punción seca en cinco músculos de la región mandibular y cervical. Resultados Tras cuatro sesiones de tratamiento se observó una mejora del dolor de la paciente y se evidenció una recuperación de la audición. Conclusiones Una intervención basada en la técnica suiza y punción seca para el tratamiento del síndrome de dolor miofascial de la musculatura temporomandibular y esternocleidomastoideo puede ser útil para mejorar alteraciones de la audición. Se sugiere la realización de ensayos clínicos aleatorizados que evalúen esta técnica (AU)

Introduction Ear pain and hearing impairment is a frequent medical consultation. Referred ear pain may be due to temporomandibular disorders and the presence of trigger points in the cervical musculature. Hearing loss is related to the presence of trigger points in the cervical and mandibular muscles. Although beneficial effects have been observed on this musculature after the use of manual therapy and dry needling, the literature on the matter is still scarce, which is why the current study was carried out. Objective To know the short-term effects of a treatment based on the Swiss technique and dry needling on the temporomandibular and sternocleidomastoid muscles on ear pain and hearing loss, in a female 24-year-old patient. Material and methods Case study. An assessment was carried out before the treatment and another at the end to evaluate its effects. A 50-minute session was held weekly for 4 weeks. During treatment, the Swiss technique was applied to 5 muscles of the mandibular and cervical region. Results After 4 treatment sessions an improvement in the patient's pain was observed and a hearing recovery was evidenced. Conclusions An intervention based on the Swiss technique and dry needling in the treatment of myofascial pain syndrome of the temporomandibular and sternocleidomastoid muscles may be useful in improving hearing disorders and otalgia. Randomized clinical trials evaluating this technique are suggested (AU)

Análisis de la efectividad de la técnica de punción seca en cefaleas: revisión sistemática / Effectiveness of dry needling for headache: A systematic review

Introducción: El uso de tratamientos no farmacológicos en pacientes con cefalea, como la punción seca (PS), está asociado a una baja morbimortalidad y a un bajo coste sanitario. Algunos han demostrado utilidad en la práctica clínica. El objetivo de esta revisión fue analizar el grado de evidencia de la efectividad de la PS en la cefalea.MétodosRevisión sistemática de ensayos clínicos aleatorizados sobre cefalea y PS en las bases de datos biomédicas PubMed, Web of Science, Scopus y PEDro. Se evaluó la calidad de los estudios incluidos mediante la escala PEDro por 2 evaluadores de forma independiente.ResultadosDe un total de 136 estudios, se seleccionaron 8 ensayos clínicos publicados entre 1994 y 2019, incluyendo en total 577 pacientes. Dos estudios evaluaron pacientes con cefalea cervicogénica, otros 2, pacientes con cefalea tensional, y otro, pacientes con migraña. Los otros 3 estudios evaluaron pacientes con cefalea de características mixtas (tensional/migraña). La calidad de los estudios incluidos osciló entre «baja» (3/10) y «alta» (8/10). La eficacia de la PS sobre los episodios de cefalea fue similar a la de los tratamientos con los que se comparó. No obstante, obtuvo mejoras significativas respecto a variables funcionales y de sensibilidad.ConclusionesLa punción seca es una técnica a considerar para el tratamiento de las cefaleas en la consulta, pudiendo utilizarse de forma rutinaria, bien de forma aislada, bien en combinación con terapias farmacológicas. (AU)

Introduction: Non-pharmacological treatment of patients with headache, such as dry needling (DN), is associated with less morbidity and mortality and lower costs than pharmacological treatment. Some of these techniques are useful in clinical practice. The aim of this study was to review the level of evidence for DN in patients with headache.MethodsWe performed a systematic review of randomised clinical trials on headache and DN on the PubMed, Web of Science, Scopus, and PEDro databases. Methodological quality was evaluated with the Spanish version of the PEDro scale by 2 independent reviewers.ResultsOf a total of 136 studies, we selected 8 randomised clinical trials published between 1994 and 2019, including a total of 577 patients. Two studies evaluated patients with cervicogenic headache, 2 evaluated patients with tension-type headache, one study assessed patients with migraine, and the remaining 3 evaluated patients with mixed-type headache (tension-type headache/migraine). Quality ratings ranged from low (3/10) to high (7/10). The effectiveness of DN was similar to that of the other interventions. DN was associated with significant improvements in functional and sensory outcomes.ConclusionsDry needling should be considered for the treatment of headache, and may be applied either alone or in combination with pharmacological treatments. (AU)

La electrólisis percutánea intratisular: una revisión sistemática / Percutaneous intratissue electrolysis: a systematic review

La electrólisis percutánea intratisular es un procedimiento terapéutico tecnológico mínimamente invasivo para el tratamiento de lesiones en el sistema musculoesquelético mediante inflamación controlada y fagocitosis para recuperar el tejido afectado. Acerca de esta, se realizó un análisis de la producción científica publicada de 2014 a 2021. El estudio se realizó por medio de una revi-sión bibliográfica sistémica siguiendo la metodología PRISMA, que incluyó el uso de fuentes de información en las bases científicas: PubMed, SciencieDirect, EuropePMC, ResearchGate, Sage Journal, Thiem Connect y PHysiotherapy evidence database (PEdro). Previamente al procesa-miento de los datos, los documentos encontrados fueron sometidos diversos criterios de selec-ción. Los investigadores concluyeron que la electrólisis percutánea intratisular resulta un trata-miento efectivo para el tratamiento de tendinopatías crónicas, cuando se realiza combinado con un programa de ejercicios enfocado en la progresión de las cargas.

This work presents an analysis of the scientific production developed between 2014 and 2021 on percutaneous intratissue electrolysis. The objective is to analyze the bibliograpHy on the diffe-rent EPI interventions. The study was carried out through a systemic review following a methodological process according to PRISMA using various sources for the collection of information, such as: Pubmed, Scienciedirect, Europe PMC, Hindawi, Cochrane, Sage Journal, Thiem Connect, Pedro, Puerta Of the investigation. Selection and quality criteria were applied to these documents, with a subsequent analysis using qualitative techniques. In conclusion, intratissue percutaneous electrolysis turns out to be a favorable tool in the treatment of chronic tendinopathies as long as it is combined with an exercise program focused on load progression.

Effectiveness of dry needling for headache: A systematic review.

INTRODUCTION: Non-pharmacological treatment of patients with headache, such as dry needling (DN), is associated with less morbidity and mortality and lower costs than pharmacological treatment. Some of these techniques are useful in clinical practice. The aim of this study was to review the level of evidence for DN in patients with headache. METHODS: We performed a systematic review of randomised clinical trials on headache and DN on the PubMed, Web of Science, Scopus, and PEDro databases. Methodological quality was evaluated with the Spanish version of the PEDro scale by 2 independent reviewers. RESULTS: Of a total of 136 studies, we selected 8 randomised clinical trials published between 1994 and 2019, including a total of 577 patients. Two studies evaluated patients with cervicogenic headache, 2 evaluated patients with tension-type headache, one study assessed patients with migraine, and the remaining 3 evaluated patients with mixed-type headache (tension-type headache/migraine). Quality ratings ranged from low (3/10) to high (7/10). The effectiveness of DN was similar to that of the other interventions. DN was associated with significant improvements in functional and sensory outcomes. CONCLUSIONS: Dry needling should be considered for the treatment of headache, and may be applied either alone or in combination with pharmacological treatments.

Efectividad de la punción seca en el compartimento medial de la rodilla en paciente con osteoartritis. Caso clínico / Effectiveness of dry needling in the medial compartment of the knee in patient with osteoarthritis. Clinical case

Objetivo: Determinar la efectividad del tratamiento con punción seca para eliminar el síndrome de dolor miofascial en una paciente con gonartrosis y puntos gatillo no miofasciales activos en el compartimento medial de la rodilla. Material y métodos: Mujer de 69 años con osteoartritis generalizada e importante deformidad en genu varum de ambas rodillas. Se valora mediante palpación la presencia de puntos dolorosos en el compartimento medial de la rodilla más limitada, y son tratados con punción seca mediante la técnica de inserciones múltiples rápidas de Hong. Resultados: Se realiza un seguimiento de 4 semanas de tratamiento mientras se registran los datos relacionados con la percepción del dolor al inicio de la técnica, durante la misma y tras ella, y se objetiva la evolución del umbral de dolor a la presión en los puntos más dolorosos del compartimento medial de cada visita. Al finalizar el estudio, se demuestra la eficacia analgésica tras el análisis del registro. Conclusiones: La técnica de inserciones múltiples rápidas de Hong sobre los puntos gatillo no miofasciales de una rodilla con degeneración medial provocada por osteoartritis es eficaz en el tratamiento del dolor y, por tanto, en el aumento de la calidad de vida de la paciente, debiendo considerarse como una opción de tratamiento válida a la hora de abordar su cuadro clínico.(AU)

Objective: To determine the effectiveness of treatment with dry needling to eliminate myofascial pain syndrome in a patient with gonarthrosis and active non-myofascial trigger points in the medial compartment of her knee. Material and methods: A 69-year-old woman with generalized osteoarthritis and significant genu varum deformity of both knees. In the medial knee compartment, the tender points of the more limited knee were palpated and treated with dry needling using Hong's rapid multiple insertion technique. Results: A 4-week follow-up of treatment was carried out, and the data relating to the perception of pain were recorded at the beginning of the technique, during and after it, along with the evolution of the pressure pain threshold in the most painful points in the medial compartment during each visit. At the end of the study, analgesic efficacy was proven, after analysis of the records. Conclusions: Hong's rapid multiple needle insertion technique in the non-myofascial trigger points of the knee with medial degeneration caused by osteoarthritis was effective in the treatment of pain and, therefore, improved the quality of life of the patient, so it should be considered a valid treatment option in her rheumatological disease.(AU)

Tratamiento del síndrome de dolor miofascial en una paciente diagnosticada de cefalea tensional: a propósito de un caso / Myofascial pain syndrome treatment in a patient diagnosed with tension headache: A case report

Introducción La cefalea tensional tiene una prevalencia importante y un fuerte impacto socioeconómico. Se considera un síndrome de dolor miofascial. El tratamiento del síndrome de dolor miofascial en la musculatura cervical posterior y craneal puede ser una alternativa al tratamiento farmacológico en el abordaje de la cefalea tensional. Objetivo Describir la presencia del síndrome de dolor miofascial en una paciente diagnosticada de cefalea tensional y determinar la efectividad de un tratamiento fisioterapéutico. Materiales y métodos Mujer de 60 años diagnosticada de cefalea tensional. Presentaba un cuadro de dolor opresivo de localización bilateral en cabeza, así como dolor y rigidez cervical. Se exploraron 23 músculos de la zona craneocervical y escapular para diagnosticar el síndrome del dolor miofascial y tratar los puntos gatillo mediante punción seca y el abordaje de Dejung. Se midió el rango articular cervical mediante goniometría y se evaluó el dolor de cabeza con la escala analógica visual del dolor. Resultados El diagnóstico del síndrome del dolor miofascial se confirmó por la presencia de 8 puntos gatillo miofasciales activos. Los resultados mostraron una mejoría clínica relevante en la variable intensidad del dolor, con una reducción superior al 25% en todas las mediciones excepto la tercera. Esta mejora se mantuvo 2 semanas después del tratamiento. Al final de la intervención el dolor remitió, desaparecieron todos los puntos gatillo iniciales activos y latentes, y se recuperaron los últimos grados de ROM para la rotación e inclinación cervical izquierda. Conclusiones El diagnóstico y abordaje del síndrome del dolor miofascial debe ser considerado en pacientes con cefalea tensional (AU)

Introduction Tension headache has an important prevalence and a strong socioeconomic impact. It is considered a myofascial pain syndrome. The treatment of myofascial pain syndrome in the posterior cervical and cranial muscles can be an alternative to pharmacological treatment in the management of tension headache. Objective To describe the presence of myofascial pain syndrome in a patient diagnosed with tension headache, as well as determine the effectiveness of a physiotherapeutic treatment. Materials and methods A 60-year-old woman diagnosed with tension headache. The patient presented a condition of oppressive bilateral headache, as well as neck pain and stiffness. Twenty-three muscles were scanned from the cranio-cervical and scapular area to diagnose myofascial pain syndrome and to treat the trigger points through dry needling and Dejung's technique. Cervical joint range of motion was measured by goniometry and headache was assessed with the visual analogue scale for pain. Results The diagnosis of myofascial pain syndrome was confirmed by the presence of 8 active myofascial trigger points. The results showed a relevant clinical improvement in the pain intensity variable, with a reduction of more than 25% in all measurements except in the third one. This improvement was maintained 2 weeks after the treatment. At the end of the intervention, the pain remitted, all the active and latent initial trigger points disappeared, and the last degrees of ROM were recovered for left cervical rotation and tilt. Conclusions The diagnosis and approach of myofascial pain syndrome should be considered in patients with tension headache (AU)

Effectiveness of dry needling for headache: A systematic review. / Análisis de la efectividad de la técnica de punción seca en cefaleas: revisión sistemática.

INTRODUCTION: Non-pharmacological treatment of patients with headache, such as dry needling (DN), is associated with less morbidity and mortality and lower costs than pharmacological treatment. Some of these techniques are useful in clinical practice. The aim of this study was to review the level of evidence for DN in patients with headache. METHODS: We performed a systematic review of randomised clinical trials on headache and DN on the PubMed, Web of Science, Scopus, and PEDro databases. Methodological quality was evaluated with the Spanish version of the PEDro scale by 2 independent reviewers. RESULTS: Of a total of 136 studies, we selected 8 randomised clinical trials published between 1994 and 2019, including a total of 577 patients. Two studies evaluated patients with cervicogenic headache, 2 evaluated patients with tension-type headache, one study assessed patients with migraine, and the remaining 3 evaluated patients with mixed-type headache (tension-type headache/migraine). Quality ratings ranged from low (3/10) to high (7/10). The effectiveness of DN was similar to that of the other interventions. DN was associated with significant improvements in functional and sensory outcomes. CONCLUSIONS: Dry needling should be considered for the treatment of headache, and may be applied either alone or in combination with pharmacological treatments.

[Efficacy of dry needling in neck pain compared with other physiotherapy techniques: A systematic review]. / Eficacia de la punción seca en la cervicalgia en comparación con otras técnicas de fisioterapia: una revisión sistemática.

OBJECTIVE: To determine the efficacy of dry needling (DN) in the treatment of myofascial trigger points (MTrP) compared to other methods of physical therapy in the treatment of neck pain. METHOD: A systematic search was carried out in the MEDLINE Complete (EBSCO), Pubmed, PEDro and Scopus databases. The quality of the studies was assessed using the standard of biases of the Cochrane Collaboration. RESULTS: Eleven articles met the eligibility criteria. The characteristics of the participants and the results of the comparison of the application of DN with ultrasound, TENS, manual therapy techniques (passive stretching, strain-counterstrain, ischaemic pressure) and kinesiotape bandage are described. CONCLUSION: DN was a useful technique in reducing neck pain. However, its efficacy in the treatment of cervicalgia could not be determined in comparison with other physiotherapy approaches.